Organization Active NPI

Regent Therapy Services LLC.

  • Physical Therapist
  • Lake Mary, FL
National Provider Identifier
1659950244
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
REGENT THERAPY SERVICES LLC.
Practice address
875 Wallace CT , Suite C (Unit 1013)
Lake Mary, FL 32746-3274
Phone
(813) 843-2401
NPI assigned
Apr 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Maulika N Thakore, PTNPI 1356522411
Title
Owner/ Manager
Phone
(813) 843-2401

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary
Orthopedic Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251X0800X

Addresses

Primary practice location

875 Wallace CT , Suite C (Unit 1013)
Lake Mary, FL 32746-3274

Mailing address

5205 Piper LN
Sanford, FL 32771-5465
Phone (813) 843-2401

Other names 1

  • FYZICAL Therapy & Balance Centers Of Lake Mary Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210813001030 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4587064571 Receives reassigned benefits from 2 practitioners
Practice locations: Lake Mary, FL

National Provider Directory

National Provider Directory

Locations

875 Wallace Ct
Unit 1013
Lake Mary, FL 32746
Phone (734) 578-5171

875 Wallace Ct
Unit 1013C
Lake Mary, FL 32746

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617321600000",
    "number": "1659950244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 PIPER LN",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327715465",
            "telephone_number": "813-843-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 WALLACE CT , SUITE C (UNIT 1013)",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463274",
            "telephone_number": "813-843-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENT THERAPY SERVICES LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A",
        "authorized_official_last_name": "THAKORE",
        "authorized_official_first_name": "MAULIKA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER/ MANAGER",
        "authorized_official_telephone_number": "813-843-2401",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FYZICAL Therapy & Balance Centers Of Lake Mary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.